HomeMy WebLinkAboutPermit Building 1994-7-18 (2)
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
OHlce: 726.3759
.
~
. .
JOB NUMBERg4Ilfs I
.~ 225 Fifth Street
~JJ Sprlnglleld, Oregon 97477
\ti~~~ .
TAX LOT:\)} n rY"'f..J!CX'Y
SUBDIVISION' J:~ l ~f'\~:
OWNE~' 0\\\ \J..Cl.Q)\ r f\'t~ (\\'\\.1 !:\O.l) ~~(\(' -PHONE: (\~. \d-{ lolP
ADDRE~: f!>l.\ ~ ~r--) ~~{J rYi Y '- f)tJ\ 0 0 "}-' .
CITy:~i \i\ t .f\n.~.j O'!) (V - STATE: ll\ 0 r,(C')f\ ZIP: a 1'" "1 <p)
'\ \\ ,\-
DESCRIBE WORK: ~f\~A Q, ~Q N\i V f +. \ ~o t\\o Qf\(')L,
NEW Y REMODEL . ~ADDITION' DEM\g),ISH OTHER
LOCATION OF PROP~E~ORK: AA \ '1
ASSESSORSj.1AP' \(:::u~()\'o(Y)
LOT' <\-~ ) . BLOCI<"
CONTRACT~~'~S I NAM C J ADDRESS'
GENERAl.:...q'{).J. U\'t\.
PLUMBING:. .lfC\ Q(t " 'Xl ~ ~o Q \
MECHANIC~'~ct.Of'\ TN,.
ELECTRICA;\'O\\ \ 0 A. f _~p'p~ ~ )
CONST.
CONl"RACTOR ,
~ll\qc;\
5 \'\ ?{1
B~ ,\q~
\ ()~'l~
Q~~1d~
~o~~\\ lo
C\? "?).ldrW.-
L\1~.A\~
QUAD AREA: ,~~Q j
, OF BLDGS' \
OCCY GROUP:, ~?, -\ "^'
\
9 ...
· OF STORIES'
WATER HEATER:
- OFFICE USE -
LAND use. \ \ '- \
· OF UNITS: . \ . ,
CONSTR. TYPE: V [V
HEAT SOURCE: '\D\-\
f.....
RANGE"
EXPIRES
fj.\,;\ .
q.\.~.
'I.f;),.
~4
FLOOD PLAIN-
ZO~ING CODE: ~\2......
~
. OF BDRMS'
SECONDARY HEAT: _. _
SQUARE FOOTAGE: ..:: \~
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. All Inspections requested belore 7:00 a.m. will be
made the same working day, Inspections requested after 7:0,0 a.m. will be made the following work day.
REQUIRED INSPECTIONS
f\iJ R~ugh M'echanlcal ~ Prior to
~ cover.
D Temporary Elactrlc
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrlcal/
Mechanlcel - Prior to cover.
r'Vl Footing - After trenches are
~ excavated. .
D Masonry - Steel 'location, bond
beams, grouting.
~Foundatlon - After forms are
erected. but. prior to'concrete
placement.
D Underground Plumbing - Prior
to filling trench.
~ Underlloor Plumbing/Mechanical
Ll>l-.Prlor to Insulation or decking.
~ Post and Beam - Prior to floor
L.1SJ Insulation or decking.
[gj Floor Insulation - Prior to
decking.
fVl Sanllary Sewer - Prior to filling
l.6.l. trench.
~ Storm Sewer - Prior to filling
trench.
~ Water Line - Prior to filling
lL::::l.trench.
r\/I Rough Plumbing - Prior to
~ cover.
f'Vil Roug'h'Electrlcal - Prior to
I....O.l cover. .
~ Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to faCing
materials and framing Insp.
~ Framing - Prior to cover.
~ Wail/Ceiling Insulation - Prior to
cover.
rzlDrywall - Prior to taping.
D Wood Stove - After Installation.
D Insert - After fireplace approval
and Installation of unit.
~ Curbcut & Approach - After
forms are erected but prior to
placement ot concrete.
~ Sidewalk & Driveway - After
excavation Is completo, forms
and'sut)..base material In place.
D Fence - When ,completed.
D Street Trees - When all required
trees are planted.
~Flnal Plumbing - When all
- plumbing work Is complete.
. .
I"Zl Final Electrical - When all
lp.. electrical work Is complete.
Ei!Flnal Mechanical - When all
mechanical work Is complete.
OJ Final Building - When all
l..Z:l"i'equlred Inspections have been
approved and building Is
completed.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set.up. and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot sq. fig.
Lot coverage
Topography _
Total helgh~~1 '\
BUILDING PERMIT
ITEM .1 ~_ F'T.
Main -1..\W
~lcO
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Tolal Fee
L~t '~pe .
.x Inte~lor
Corner
Panhandle
Cul.de-sac
x S/SQi)
&.
/4.10
(A
!:? I\'):"~ 1\,!,;",:,~'j:.~.'I-!;:Ui!,~f<.
':h,,:,'i ,"" ,.... ;;\,"1;4.~,
.,' , ,. Setb tcks. ".
I ;P.L HSE GAR ACC'
IN.
Is
Iw
IE
:~
:., THE PROPOSED WORK.tN THE. .
. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPRove",. .
J
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
nils permit Is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City. of Springfield, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
, upon violation of any provisions of said ordinances.
Plan Check Fee: ,,: '\t--\ J ./
Date Paid: . ~
Receipt Numberu V
Received By: ~
~~lw
f). \~ %
Date
SYSTEMS DE~ELOPMENT CHARGE (SDCh
. (B) ~O ~~-'1'7
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N' c!}..
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
FEE
u.oO.aJ
L/r>UOO
+80 +- (3 ,ex>
(C) 172.~U
N' ?-.
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
.50\
(D)
MISCELLANEOUS PERMITS
Mobile Home
State issuance
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) e~:J6.~
(A, B, C, 0, and E Combined) r!)')/{). _ J
State Surchar9l\
Sidewalk ~l/
Curbcut rOCo fI
fI
Demolition
S't'l(' surch'R~ C).
, l<g h\ V\(). ~UJJ
4.ffi
q.CO
'<~.OO
llD .:SU
I 0/50
.f3~
~
rJ()W
\~.q() ,
4l)q?
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
~~ jf'r\ r-S _ &0 0 Q \ 'Xl'i!J:y
-
\ ~~\" \(\,mJ (..u)1 )
"-- ~ f\1\.Q.K : \ q to n
~~ \
Wl\\nr{\f~~,w-~~\\~Nt _
\ M'l~HJ\O~ \~~f( _\.1\\)\d.~
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify thet all
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done In accordance
with the Ordlnanc~s of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will. be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all required Inspections are
requested at the proper lime; that each address Is readable
. .
from the street, that the permit card Is located at the front
of the property, and the approved set of plans II remal n
on the. site at ~II W'es durln~stru
Signature _ ~~/; I.
Oat". J-) r4A
I
VALl DATION: ;")
,',"'''' "'"'Yf.~ /
DATE PAID . '1
. ~
AMOUNT REceJ';D^ ~ . ~
RECEIVED Bf~ )
=-~~3S.n.....
ATTACHMENT Bl
~B NO.
CITY OF SPR~GFIELD SYSTEMS DEVELOPMEN"CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
~.."....
C\4\CS \
N/1J'1E OR COMPANY: 1I-;4~.~,
LOCATION: 3,)~ &-~ /)/?, .
DEVELOPMENT TYPE: 5~/?
BUILDING SIZE: ~-
1. STORM nRATN~
IMPERVIOUS SQ. FT. ~/?"C;
2. SANlIARY SFWFR-CTTX
NO. OF PFU'S IV
(See Reverse)
3. TRANSPORTATTON
I.OT SFj; ~ SQ. Ft.
X $0.209 PER SQ. FT. $ ~S~, 1""7
X $43.26 PER PFU $ 716'." '8'
NO OF UNITS X TRIP RATE X COST PER TRIP
I X J,ol X $436.19 $ ~40..>~-
X
X
X $436.19
X $436.19
$
$
SUBTOTAL (ADD ITEMS 1.2. & 3) $
4. SANlIARY SFWFR-MWMC
NO. OF PFU'S /~ x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ 31 '1, ~ 2
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE> $ 3'?, '- C>
. . IQIAI -MWMC SDC $ ~~"f:."'~
SUBTOTAL (ADD ITEMS 1.2.3 & 4) s I '1c.o, 92.
5. ADMINISTATTVj; j;j;j;~
BASE C~ (SUB)J~OVE) X .05
~~ ,ai~, Date: ~-/.;t-- 9'9
Aary r ;g, P.EV
SDC Coo inator
$ '1 Y;O$
TOTAl SDC
$ ;205"~.? 1
B2.SDC .
FIXTURE UNIT CALCULA TION TABLE: Number of New Fixturcs X Unit Equivalcnt = Fixturc Units
(NOTE: For remodels, calculate only t~ additional fixtures) .
. . NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
z
4
Bathtub..................................................................... .
Drinking Fountain.......................... ..................... ......
Floor Drain. ........ ............................................. ..........
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher......... ................. .........
Clotheswasher. 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator/Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single StalL................................................
Shower, Gang......................................................:...
Sink: Bar, Commercial, Residential Kitchen........................
Urinal, Stall/Wall..:....................................................
Wash Basin/Lavatory, Single..................................
Toilet, Public Installation........................................
Toilet, Private.......................................................
Miscellaneous:
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
z.
/
I
'2.
2..
2..
2.
If
17
TOTAL FIXTURE UNITS
=
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table.
calculate credits separates.
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
1980
1981
1982
1983
1984
1985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
1985
1986
1987
1988
1989
1990
1991
1993
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
y,-!r:. X $ /0.077-0
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
3~c; "
------
Credit for Parcel or Land Only If Applicable
=
Improvement (if after annexation date)
=
CREDIT TOTAL = $ ~60
r